This invention relates to methods for the treatment of stimulant abuse and addiction.
In the mid-1980's, the use of the stimulant cocaine reached epidemic levels in the United States, and even today abuse of this drug remains widespread. In 1995, the Substance Abuse and Mental Health Administration reported that nearly 2.5 million Americans admitted occasional and 600,000 admitted frequent cocaine use. The adverse societal and health consequences stemming from such cocaine use are significant. First, there is the hidden toll of emotionally and psychologically damaged families dealing with a family member having a cocaine dependency. And second, there is the adverse exposure to potentially detrimental health consequences associated with cocaine use and abuse.
Although historically the frequency of hospital admissions associated with cocaine abuse has been relatively low (0.35-3%), hospital visits stemming from a cocaine-related event now appear to be on the increase. In addition, the case report literature illustrating catastrophic neurologic and cerebrovascular complications in cocaine users is also rapidly growing, and the incidence of cocaine-related strokes has been characterized as reaching epidemic proportions. Surprisingly, many cocaine-related deaths are not associated with any major brain pathology upon autopsy, yet patients have been observed to show signs associated with moderate to severe cognitive dysfunction.
Moreover, experts in this area have observed that even during periods of cocaine abstinence cognitive abnormalities persist, suggesting that brain dysfunction occurs and is maintained beyond the period of acute cocaine intoxication. The "clinically silent" nature of these abnormalities implies that substantial numbers of cocaine users may be afflicted with defects as yet undiagnosed. The etiologies of these subtle changes have not been elucidated, although cocaine-induced vasoconstriction and vasospasm have been implicated.
To date, there are no approved pharmacotherapies for cocaine abuse and dependence although the need for such therapies is clear.